A Clinical Prediction Model for Adnexal Torsion in Pediatric and Adolescent Population
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Topic overview
Abstract
Purpose
To describe the clinical characteristics of children and adolescents that underwent diagnostic laparoscopy for suspected adnexal torsion (AT), and to develop a prediction model for preoperative detection of AT among young women.
Methods
A retrospective cohort study. We included all girls ≤18 years old with clinically suspected AT who underwent a diagnostic laparoscopy between 3/2011 and 6/2020. We compared patients with AT to those without AT and constructed a prediction model.
Results
Overall, 120 children and adolescents with suspected AT were included in the study. Of those, AT was identified in 83 (69.2%).
In a multivariate analysis, the following risk factors were independently associated with AT and included in the prediction model: absence of right lower quadrant tenderness upon examination [adjusted odds ratio (aOR) (95% Confidence interval (CI)) 3.23 (1.23-8.47), p=0.017], platelets level >240K [aOR (95% CI) 3.15 (1.19-8.36), p=0.021], and neutrophils level >5.4 [aOR (95% CI) 2.71 (1.02-7.52), p=0.046].
The rate of AT was 12.5% in cases without risk factors for AT, 56.7% with one, 68.8% with two, and 94.1% with three risk factors present, respectively.
Conclusions
We have identified preoperative indicators independently associated with surgically confirmed AT in a large cohort of young women.
Level of evidence- III
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